Journal of the Endocrine Society · Oct 26, 2026

The relationship between cardiometabolic disease and vertebral bone strength, mineral density, and mass in US adults

By Wright NC, Hossain R, Bouxsein ML et al.

CONTEXT: Cardiometabolic disease (CMD) may increase vertebral fracture risk through deterioration in bone structure and/or tissue properties, compromising bone strength. OBJECTIVE: Evaluate the relationship between CMD and vertebral bone measures. DESIGN: Cross-sectional. PARTICIPANTS: Coronary Artery Risk Development in Young Adults (CARDIA) study participants with year 25 (2010-2011) abdominal computed tomography (CT) scans (n = 2728). EXPOSURE: CMD (abdominal obesity, diabetes mellitus, dyslipidemia, or hypertension) status (≥1 vs 0) and burden (0, 1, 2, ≥3). OUTCOME MEASURES: Vertebral strength, volumetric bone mineral density (vBMD), and bone mass, obtained via biomechanical CT analysis. METHODS: Multivariable linear regression evaluated the association between CMD and vertebral bone measures. Sex-specific models were adjusted for age, race, height, weight, and additional social determinants of health, lifestyle factors, and comorbidities. Effect modification by race, age, and menopausal status was evaluated. RESULTS: Overall, at least 1 CMD was identified in 72.3% of men and 70.5% of women. In the fully adjusted model, CMD status was significantly associated with lower total (β = -6.32 mg/cm³; P = .018), trabecular (β = -4.53 mg/cm³; P = .048), and cortical (β = -6.63 mg/cm³; P = .034) vBMD in men. Greater CMD burden was associated with lower total and trabecular vBMD. The negative association between CMD and vBMD was stronger in men ≤50 years. There was no association in women. CONCLUSION: In this biracial cohort of Black and White adults from the United States, CMD was associated with significantly lower total and subcompartment vertebral vBMD in men.

doi.org/10.1210/jendso/bvag193 Open access PubMed 42936172 Populations